I work for a caring oncologist who frequently recommends hospice for patients with terminal cancer. But some families reject his advice, saying that hospice pushes morphine and that makes patients die too soon. How can I convince them otherwise?-C.Y., KAN.
|Figure. No caption available.|
Hoping to delay dying as long as possible, a terminally ill patient and her family may resist hospice care. By the time she enters the program, her condition may be imminently terminal and her pain poorly controlled. When the hospice team provides an appropriate dosage of morphine to manage pain, the patient may die. But she doesn't die from the drug, but from her extensive disease.
Unfortunately, many people-including some nurses and physicians-believe the myths about morphine. They may not understand the drug's value in treating dyspnea. Some prescribers order subtherapeutic doses for pain because they fear triggering addiction. Morphine, named for the Greek god of sleep, is often falsely accused of causing death when it actually relieves suffering, allowing patients to more fully live whatever time they have left.
Teach patients and their families that small, frequent morphine doses help relieve that frightening sensation of breathlessness, a common end-of-life symptom. Yes, morphine can depress respirations, but that's just the action we want for a patient with tachypnea and dyspnea. By educating patients and their families about the benefits of morphine, you can dispel the myths that may prevent them from accepting hospice care.